Annual Question Time - 'Media - Friend or Foe?': How and why you should make the media work with you

At a time when the media is becoming ever more important to the pharmaceutical industry the Pharmaceutical Marketing Society's annual Question Time meeting brought together an expert panel to discuss how the relationship between the industry and the media can be improved. Held at the prestigious Reform Club in London's Pall Mall, professionals from the national and trade press, PR agencies, and the ethical pharmaceutical industry shared experiences on working successfully with the media. Topics included:

• Why the relationship between the media and the industry is not more positive and what can be done to improve it
• What drives the media in its coverage and does it live up to its responsibility of providing accurate information to the public
• How the industry should approach a media/PR campaign.

(back row l-r) Colin Cooper, Nigel Hawkes, Steve Mackenzie-Lawrie (Vice-Chairman PM Society), Neil McCrae, Michael Brown (front row l-r) Jenny Hope, Trevor Jones, Mike Gale (Chairman PM Society), Jo Spink

Loved and hated
In the words of meeting chairman Trevor Jones (Director General of the ABPI), the pharmaceutical industry is currently both loved and hated by the media. One day they carry a piece about the innovative nature of the business, with a breakthrough for treating cancer, HIV/AIDS or malaria, the next day industry is depicted as neglecting the developing world and exploiting the poor. In his capacity as member of the Commission of the World Health Organization Trevor Jones was actually accused recently of having patents that were 'weapons of mass destruction'.

The pharmaceutical industry has learned to live with this kind of ambivalent attitude. This PM Society meeting set out to examine how the relationship between industry and the media can be put on a more positive footing. Is there a moral right in our society for the media to challenge precepts so that industry is called to account? If so, how does the industry meet that challenge?

Stories are key
In the view of Nigel Hawkes (Health Editor of The Times) no industry has a wholly positive relationship with the media: every industry thinks the media hates them. However, the opposite of a bad press is no press at all. The media don't write about trains that run on time but about trains that crash. In the same way the media won't write about drugs that cure patients. Instead they write stories - interesting stories, often about things going wrong.

This does not mean that the media are anti-pharmaceuticals. According to Nigel Hawkes, in all that really matters the media are on the industry's side: the need for research, the need to market products as soon as they are approved, the defence of animal-based research, and the right to a proper return on investment.

Where the relationship is under some strain is when the media are asked to do too much. To compensate for the fact that the pharmaceutical industry cannot advertise direct-to-consumer - something which in Nigel's view is absurdly out of date - it strives more than most industries to get positive media coverage, hence the proliferation of health-related public relations. In reality there is a limit to what this can achieve. Of all the calls Nigel receives each week from PR agencies on drug-related issues there are relatively few stories he can write. If a new drug is significantly better than one already on the market, if it is licensed but unavailable, or if there is a new trial proving its effectiveness, only then might he be able to write a story.

In Nigel's view, nobody 'at the coalface' in the media is driven by circulation figures. News editors want good stories. Do journalists have any expectation of finding the truth? Generally they write about balance rather than the truth - this is not especially healthy but it is a fact.

And remember, if the media run with a 'health scare' then prompt response from the industry is essential, preferably as a united front. Feeding the media stories was likened to 'pushing a bun through the bars of a bear's cage. This is easy, however getting that story back is not. There is no guarantee that the media will be your friend. This may be frustrating for the industry, but it is in fact just as frustrating for the media.

Shades of grey
According to Neil McCrae (GlaxoSmithKline) both industry and the media have important jobs to do. The industry is in the business of developing drugs that save lives, and help people live healthier and more active lives. Media coverage can raise awareness about new treatments, educate patients and raise genuine concerns where they exist. The media have a right and duty to report what they see as the truth although they don't always get it right and the resultant damage can be significant. Difficulties can arise when non-specialist journalists, unaware of the wider issues of medicine and the pharmaceutical industry, get hold of stories. This can be compounded by the mainstream media's desire for black and white certainty in a story, not recognising that medical knowledge and advances in science are often about shades of grey.

A good story must include people as well as statistics. Also, in Neil's view, the reporting of risk is not always handled well by the media. He gave the example of a study which showed that high levels of nicotine increased the growth rate of existing tumours in mice. Yet this story was run under the headline, 'can nicotine patches cause cancer?' The result was that some people were put off using an effective treatment that has been shown to double chances of stopping smoking. And the minuscule theoretical risk mentioned in the coverage didn't even begin to compare with the known and deadly risks of tobacco. The BBC has now introduced guidelines on the reporting of risk, which consider how the risk has been measured. If this proves effective, the hope is that other areas of the media will follow.

Neil believes that pharmaceutical companies can do more to help journalists understand the workings of the industry, specifically demonstrating the passion of people in R&D who are striving to develop new medicines.

Miracle or disaster
Jenny Hope writes on health issues for 6 million Daily Mail readers. Her stories have to be accurate but complex issues need to be summarised and written to a lay audience in only 600 800 words maximum. Stories must have interest for her readers and generally this means either 'miracle' or 'disaster' and the press thrives on disaster.

When the industry wants the media to 'puff' a drug, the driving force has to be something new - a new application of an old drug, or new side effects for an existing drug. Recent drug-related stories carried in the Daily Mail have included Levitra (GSK's new drug for impotence), safety concerns about Seroxat, mercury content in vaccines, and whether Viagra may damage sperm - a balance of positive stories and health issues. Jenny stressed that there is no hidden agenda. At the coalface, circulation is remote. A good story is more important. But it is vital that the industry and PR remembers the ad hoc nature of daily journalism: the editor will always judge issues 'on the day'.

The recent anti-HRT coverage in the media has been driven by published peer-reviewed research. Daily Mail readers care about HRT and much of what has appeared in the newspaper has been driven by the editor's own confusion about the research findings. What are the media supposed to think when the evidence appears to be conflicting? Jenny's aim is always to provide balance, and not to endorse the more maverick claims. But there is genuine concern among readers about health scares. Scare stories are not generally made up by the newspapers remember that there was no argument about the 1995 pill scare and that was controversially generated by the Government's own drug safety advisers.

When providing stories to the newspapers, researchers and PRs need to:

• Ensure that clear lines of contact are established in advance
• Consider what the newspapers want from a story
• Always provide a hook.

Perhaps most important is to remember that patients themselves now have ready access to information via the internet. Patient groups are becoming increasingly active. In Jenny's words, the information genie is out of the bottle.

Consider your audience
The biggest frustration in healthcare PR is that clients' true understanding of the media is in fact very limited, according to media trainer Michael Brown. Clearly the PR industry has failed to educate its clients in understanding how journalists operate. In Michael's view the best way to get attention for stories in newspapers, television and radio is to consider target audiences. Think of an imaginary reader who represents the audience for your particular story, e.g. a 38-year-old woman with teenage children and who watches soaps on television. A corporate press release about a new drug aimed at City editors and company shareholders will have no interest for the readers of the Daily Mirror. If the audience is taken into account more stories will be published.

In producing stories for journalists the industry has to concentrate less on its brands and more on ensuring that everyone involved understands how the media works. Plenty of good stories are lost because somebody in the company sits on the detail for weeks. Delays and sloppiness in targeting audiences are the real challenge.

Most important of all, media relations are not just the responsibility of PR companies or even the marketing specialists. Everyone, from the person on reception to the Chairman of the Board, needs to be aware of the media, and what might make an interesting story.

According to Michael Brown, media coverage is there to be had. Journalists are looking for good stories and the audience is waiting to hear them. The industry's mission must to be to ensure that those stories get published.

Realistic expectations
As editor of GP Magazine, a national newspaper specifically for GPs, Colin Cooper knows his audience. However, the fact that it is a free publication (relying almost exclusively on pharmaceutical advertising for income) brings tensions and he walks an editorial tightrope balancing the interests of readers and advertisers while at the same time producing a high-quality editorial product.

Colin Cooper suggests that three key areas characterise any successful working relationship: knowledge, trust and maturity.

• Knowledge
  • Know the publication you are working with its audience, agenda, style, structure, and regular features.
  • Know the deadlines - don't call on press day!
  • Know the staff structure who is responsible for what. Know the two big names - in GP Magazine that means the Clinical News Editor and the Clinical Features Editor.
  • Know what to send if you send data make sure you include the abstract and the methodology of the study.
  • Know what the publication is interested in GP Magazine publish stories that directly affect GPs and their patients in primary care (not secondary care). The simple test is whether the story will make GPs consider changing their everyday clinical practice

     

• Trust. This means openness, honesty and reliability.
  • When the media come to you for information they need to reach the right person quickly and easily.
  • The ABPI Directory is very useful but in many cases does not include direct lines and e-mail addresses for named contacts. The media will never trust 'info@' or 'corporate-comms@'.
  • Information should be accurate and stories should be genuine. The media can see through spin. If a journalist feels they are being given the full picture they are more likely to trust you - then and in the future.

     

• Maturity. Namely understanding, respect and taking the long view.
  • You will have to face a difficult story in the media at some stage. It will be easier to confront the issues if you already have a good relationship with the media.
  • If you know something potentially damaging is coming up, talk about it in advance.
  • Have realistic expectations. At the GP Magazine there is huge competition for space. Learn to take 'no' for an answer.
  • Don't pester. If you want to improve your relationship with medical journalists:
    • Don't call to ask if they received your press release.
    • Don't call to ask if the story is going in the paper - they can't give a firm answer because they won't know until the last minute.
    • Don't call to ask for copies of the issues which have included your stories. Subscribe!

Don't forget the other vital ingredient in a successful relationship - fun. This means events and parties - all journalists like to enjoy themselves, gossip, get the inside story, and find new contacts. These events help give the industry a human face.

The patient as consumer
Speaking from the PR agency perspective, Jo Spink believes that the media is a good friend to the pharmaceutical industry and a powerful ally in improving the health of the nation. The media has power. Within healthcare, more and more lifestyle brands (like Levonelle and Viagra) are being built through the media. The success of the contraceptive Yasmin in Ireland is down to women knocking on GPs' doors and asking for it because of positive media coverage.

Media support was also vital in the fight for funding for beta-interferon throughout the NICE appraisal process. The success was built on featuring emotive true-life stories showing the impact of a drug on a person's life. In this way the media can influence sales.

Now that the future of the NHS is very much patient-focused we are increasingly seeing a shift from 'physician push' to 'consumer pull' and consumers will undoubtedly become the biggest prescribing driver. The media have unrivalled influence over this target audience with the power to raise awareness of a disease, drug, service or treatment.

Even a small mention in a national newspaper reaches not just consumers but also clinicians. In fact, the media have unique access to all the pharmaceutical industry's customers' - patients, fundholders, and shareholders. They can also build a brand, empower patients, build credibility, and boost confidence in your product and your company (and your share price). Of course, the media also have the ability to do the reverse. So they hold your livelihood in their hands. Remember, the media don't create the news, they report it.

Talking points
Trevor Jones opened up a lively question-and-answer session asking if it is acceptable for journalists to cause alarm? Where does the journalist's responsibility lie? Jenny Hope agreed that it is hard for journalists to stick to a responsible line if other media adopt an irresponsible approach. The pill scare in the mid 1990's was handled clumsily by the regulatory agency not allowing the key stakeholders in the industry a voice, let alone the women themselves. And once that black mark was there it was very difficult to erase.

Tracey Brader (Brader Perryman) works on the advertising account for Xenical. She pointed out that press coverage focuses on the obesity epidemic rather than on prevention and the anti-obesity agents that exist to support clinically obese people. Michael Brown felt that people don't yet trust anti-obesity agents and the media need positive examples where these agents have been successful in order to convince people of the benefits. Obesity is currently a hot topic and good case stories will get published. He pointed to the adage 'Don't tell me, show me!' Journalistically, the single example case study works and is the key to awareness.

Trevor Jones remembered Chris Mihill (former Medical Correspondent of the Guardian) saying that he would go to a bike shed in Acton on a rainy night to get a good story, rather than attend a champagne reception at Claridges. On this point, Lance Chappell (Ferring Pharmaceuticals) was interested in what actually makes a good story. Problems like death rates from alcohol, hospital infection rates, and road accidents never seem to get in the news yet a relatively small number of women developing breast cancer on HRT receives a disproportionate amount of coverage. Why is this?

Nigel Hawkes felt that there is always the underlying worry about cancer. Also, as Jenny Hope pointed out, some stories take on a life of their own. The press are always interested when things go wrong. If she writes a 'good' story on statins and then gets a call from someone whose life has been ruined by them that anecdote drives her to look at statins in a different way.

Asked by Helen Brown from Roche whether more consideration should be given by the media to the impact on the NHS of driving patients to request particular treatments, Nigel Hawkes was adamant that this should not be a consideration in publishing stories: it is not the media's job to do the Government's rationing. Colin Cooper mentioned that doctors have actually identified the Wednesday morning 'Daily Mail consultation', driven by patients reading about a particular treatment in Tuesday's newspaper. That's why GP Magazine started the page 'Behind the headlines'. Neil McCrae pointed out that patients in the UK receive new treatments later than in most other parts of Europe. There is nothing wrong in the media encouraging patients to talk to their GP because there may be something that can help them.

Sandy Thomson (PM Society and Novartis) asked about direct-to-consumer advertising (currently forbidden under European law) and the position of disease awareness campaigns. While Nigel Hawkes can see no rational reason for prohibiting DTC advertising it remains the context in which marketing campaigns must be conducted. Jo Spink stressed that disease awareness campaigns allow industry profits to be used to improve the nation's health. Whether as a general campaign or via patient groups, either way the industry gets good press.

Trevor Jones came back to Colin Cooper's point that many in industry and PR do not know their own media. Michael Brown stressed that sometimes the problem lies with those that manage PR budgets: PR agencies are often ordered by their clients (particularly US clients) to send out material that isn't a story. Chris Mihill agreed that product managers need educating - there is gold-dust in any study and a story can always be found.

On the topic of Botox, Judy Williams (Allergan) asked how realistic it is to expect a journalist to check out all the facts on a scare before writing a story. Jenny Hope felt that the specialist health journalist will have a reputation and contacts to maintain but unfortunately generalists sometimes don't check facts. Judy added that since her company invested a lot of time in building good relationships with journalists they have seen a phenomenal difference in the level and accuracy of reporting on Botox.

The take-home message is clearly that it is worth investing time in building a relationship with the media. Trevor Jones firmly believes that industry should not regard the media as a foe and should think of the relationship as being symbiotic. The media can help you, but to make it work you to need to help them. Jo Spink suggests the following:

• Invest time, effort, resources and expertise in talking to the media
• Shift the focus to the patient, i.e. the reader/audience, and consider their quality of life and the emotive benefits of a particular treatment.
• Be brave and undertake disease awareness campaigns embrace the true role of healthcare provider and offer more than just drugs.
• Adopt a positive attitude. Go away today and ensure that your PR agency and in-house personnel research the needs of the media and offer them what they want. The media report the stories, they don't create them.

Held on: 21/04/2004